Antiphospholipid syndrome related to miscarriage complications?

The article was professionally consulted by Specialist Doctor I Pham Thi Yen - Department of Obstetrics and Gynecology - Vinmec Hai Phong International General Hospital. Doctor has more than 10 years of experience in examination and treatment in the field of Obstetrics and Gynecology.

Antiphospholipid syndrome is an autoimmune disease that causes hypercoagulability. Pregnant women with Antiphospholipid syndrome are at increased risk of miscarriage, stillbirth, and other serious reproductive problems.

Antiphospholipid syndrome (also known as antiphospholipid antibody syndrome) is an autoimmune disease. When suffering from this disease, the antibodies in the patient's immune system mistakenly recognize phospholipids as harmful substances and attack, while phospholipids are the components that play a role in the structure of cells. As a result of this condition, cells are damaged. These injuries lead to the formation of blood clots in the arteries and veins, and it is these clots that cause the dangerous nature of the disease.
Normally, blood clotting is a normal phenomenon for the body. This process is needed to help small wounds or broken blood vessel walls stop bleeding and heal faster. However, with Antiphospholipid syndrome, the blood clots excessively, blocking the flow of blood and causing a series of dangerous effects on all parts of the body. Anyone can develop antiphospholipid antibody syndrome, but it is more common in women than in men.
Especially for pregnant women, if you have Antiphospholipid syndrome, it will increase the risk of miscarriage, stillbirth and dangerous complications related to pregnancy.

Antiphospholipid syndrome is one of the causes of recurrent miscarriages (≥ 3 times). On the other hand, about 20% of women with recurrent miscarriages are diagnosed with immunological causes, most commonly due to antiphospholipid syndrome in pregnant women.
Thus, it is clear that the presence of Antiphospholipid antibodies is closely related to the ability to induce miscarriage. Scientists have studied and discovered the mechanism of this association. The results show that antiphospholipid antibodies have an effect on activating platelets, epithelial cells, monocytes and thereby mediating the coagulation process, leading to arterial thrombus formation. and veins. They also affect the infiltration of trophoblasts, leading to aberrations in placental activity and an increased risk of recurrent miscarriage. Antiphospholipid syndrome also activates a system of chemical mediators that induce a proinflammatory response through this immune mechanism.

Pregnant women with Antiphospholipid syndrome will test positive for anti-cardiolipin, lupus anticoagulant or anti-beta-microglobulin antibodies and have a history of thromboembolism or complications during pregnancy (restricted fetal growth). in utero, severe preeclampsia, intrauterine stillbirth, or recurrent miscarriage). To diagnose this syndrome, it is necessary to perform antiphospholipid syndrome tests, including the presence of at least one clinical criterion (eg, recurrent miscarriage, signs of thrombocytopenia, venous thrombosis, etc.) concurrently have positive results in the antiphospholipid antibody test (of one of the three antibodies) at least 2 times within a period of approximately 12 weeks. In general, there are many diagnostic and therapeutic challenges for these conditions.

Currently, there is no method that can cure Antiphospholipid syndrome completely, but there are many therapeutic measures that can limit the pathogenesis. Specifically, the combination of unfractionated heparin (natural heparin) and aspirin has been shown to reduce miscarriage rates and increase fetal survival. These two drugs inhibit the formation of blood clots and regulate the immune system. Both of these mechanisms provide positive patient benefits.
Overall, studies have been shown to use unfractionated heparin 5000 - 10,000 IU twice daily in combination with 81 mg of Aspirin. For low molecular weight heparin, many studies have also been done but the effectiveness is still unclear. In addition, steroid therapy and the use of intravenous immunoglobulins have also been tried, but the reported results are controversial.
The most likely reason for the discrepancy between the results is the heterogeneity of the studies performed: Criteria for identifying patients differ, testing facilities are chosen, and antibody testing is different together. Besides, the study of the treatment process is started at different stages of pregnancy and the effect on each patient with Antiphospholipid is not the same.
In addition, it is also important to have good control of other conditions caused by Antiphospholipid syndrome (such as lupus) as this will help prevent potentially serious complications.
If you have unusual symptoms, you should be examined and consulted with a specialist.
To protect mother and baby during pregnancy, Vinmec provides a package Maternity service to help monitor the health status of mother and baby comprehensively, periodically check antenatal care with leading obstetricians, perform full range of tests, important screening for pregnant women, timely advice and intervention when detecting abnormalities in the health of mother and baby.
For detailed information about all-inclusive maternity packages, please contact the hospitals and clinics of the Vinmec health system nationwide.